MEDICARE: NORTH SURGERY CENTER LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	096	TN
2	261QA1903X	Ambulatory Surgical Clinic/Center	0000000096	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	490004005	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3100749	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1154391340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SURGERY CENTER LP

Provider Business Mailing Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	SUITE 100
City	:	MEMPHIS
State	:	TN
Zip	:	38128
Country	:	US
Telephone Number	:	901-373-1991
Fax Number	:	901-516-1755

Provider Business Practice Location Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	SUITE 100
City	:	MEMPHIS
State	:	TN
Zip	:	38128
Country	:	US
Telephone Number	:	901-373-1991
Fax Number	:	901-516-1755

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. SHERRYE B CRONE
Credential	:	RN
Telephone Number	:	901-516-1716

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	02/01/2012

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Directions to “NORTH SURGERY CENTER LP ” Practice Location

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